The 32 members of the American Medical Association (AMA)/Specialty Society Relative Value Scale Update Committee, or RUC (rhymes with “truck”) have an outsized role in keeping medical practice financially viable. The RUC seeks to explain the resources required to provide medical services and makes recommendations to the Centers for Medicare & Medicaid Services (CMS) to inform the resource-based relative value scale (RBRVS) that underpins Medicare’s physician fee schedule. CMS typically accepts over 90% of the RUC’s recommendations each year. To paraphrase Winston Churchill, never have so many physicians (and other health care professionals) owed so much to so few.
To do this work, RUC depends on specialty societies to distribute surveys that ask physicians and other health care professionals to evaluate the work involved in new, revised, and potentially misvalued services. The American Academy of Family Physicians (AAFP) and other specialty societies rely on members to complete these surveys to inform their recommendations to the RUC, which subsequently inform the RUC’s recommendations to CMS.
The AAFP emails RUC surveys to randomly selected members with the subject line, “RUC Survey | We Need Your Input.” The surveys ask physicians to use a list of 10 to 20 common, well-established services as reference points to compare to the work required for the new, revised, and potentially misvalued services that the survey seeks to evaluate. The surveys ask physicians to estimate the time required to provide the services, as well as the relative intensity and complexity of those services compared to the reference points.
As mentioned, Medicare typically accepts nearly all the RUC’s recommendations, and many other payers then tie their fee structure to Medicare's. Additionally, many organizations that employ physicians have productivity provisions that rely on Medicare’s RBRVS in their employment contracts. Consequently, it is hard to overstate the importance of RUC surveys, and how influential they can be for physician payment. This is what makes it so important for family physicians to complete the surveys.
The AMA has additional information on the RUC and its role in advising Medicare on how to value a physician’s work.
— Kent Moore, AAFP Senior Manager, Payment Strategies
Posted on Dec. 6, 2023
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